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CLYDE A RICHARDSON M DIV CAC-R
NPI 1275709826
Counselor - Addiction (Substance Use Disorder) in Grand Rapids, MI

Active since May 05, 2008
3210 EAGLE RUN DR, SUITE 200, GRAND RAPIDS, MI 49525(616) 957-1200(616) 957-1297 Get Directions Write a Review

NPPES record last updated: June 26, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Clyde A Richardson M Div Cac-r NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLYDE A RICHARDSON M DIV CAC-R (NPI 1275709826) is an individual addiction (substance use disorder) provider in Grand Rapids, Michigan, licensed in Michigan (6802067415) and active in the NPI registry since May 2008.

NPPES Registry Identity

NPI1275709826
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameCLYDE A RICHARDSONCredential: M DIV CAC-R
Location Address3210 EAGLE RUN DR, SUITE 200Grand Rapids, MI 49525
Mailing Address3210 Eagle Run Dr, Suite 200Grand Rapids, MI 49525 · (616) 957-1200 · Fax (616) 957-1297
Phone(616) 957-1200
Fax(616) 957-1297
Sole ProprietorNo
Enumeration DateMay 5, 2008
Last NPPES UpdateJune 26, 2009
✔ NPI 1275709826 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in MI · 6802067415
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 6802067415 (MI)
Also ListedCounselor · PastoralTaxonomy 101YP1600X · License 6802067415 (MI)
3210 EAGLE RUN DR, Grand Rapids, MI 49525
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MICHAEL K. KIVINEN MA, LLP, CHT
Psychologist (Clinical)
3210 EAGLE RUN DR, SUITE 200
GRAND RAPIDS, MI 49525
Kent County (616) 957-1200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clyde Richardson's NPI number?

The NPI number for Clyde Richardson is 1275709826. It was assigned to this individual provider in the NPPES registry on May 5, 2008.

Where is Clyde Richardson located?

Clyde Richardson practices at 3210 Eagle Run Dr Suite 200, Grand Rapids, MI 49525. The listed phone number is (616) 957-1200.

What is Clyde Richardson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Clyde Richardson was last updated on June 26, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.